Dr. Jennifer Tores-Velazzo does a case study about an HIV-infected patient from Brazil and reviews recommendations for the diagnosis of HIV. She touches on the differences between HIV-1 and HIV-2 viruses and their groups and subtypes – HIV-2 does not respond to NNRTI treatment. She explains the traditional direct ELISA test (Western Blot) and the 3rd and 4th generation testing done with the Sandwich ELISA method, and touches on nucleic acid amplification and immunofluorescence assays as confirmatory tests. She discusses the timeline for detection of different parameters – HIV RNA, HIV-1 p24 Antigen, and HIV Antibodies, as well, as window periods where test parameters are undetectable. She goes over the updated FDA recommended algorithm for the use of 4th generation testing for HIV infections, and their pitfalls, ending with recommendations on which tests to order to screen for HIV.
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